Time to get head in game on concussion

DID you notice the publicity this week as the revised Scottish Concussion Guidelines were published?

These guidelines are an update of the initial work done in 2015 where, for the first time in the world, medics, sports governing bodies, Scottish Government and sportscotland, the national agency for sport, came together to produce a single concussion policy for all sports.

The 2018 guidelines represent the consensus of international expert opinion. I have been privileged to have been part of the expert group since the initial guidelines were drafted.

While concussion understanding has progressed rapidly in the past decade, there remain many unknowns – in particular about the medium and long-term consequences of repeated poorly managed concussions. These updated guidelines are designed to shape a consistent, accurate message.

So what’s new for 2018? Where the previous guidelines advised rest as the main treatment for concussion, the advice now is that, like any other injury, the brain needs to rehabilitate rather than rest.

A concussed brain should be challenged in controlled step-wise increases in function to rehabilitate it back to a normal life as the first priority, and then again step-wise increases in physical activity to get back to sport. Young developing brains need slower rehabilitation hence the minimum times for return to sport are different for adults, adolescents and children.

Elite sportsmen and sportswomen have the benefits of expert medical back-up at pitchside and to plan and monitor their rehabilitation with often daily reassessment. At grassroots level all who work with those participating in sport have a duty to be informed to ensure that it’s the safest playing environment possible for participants to enjoy an active lifestyle.

Injuries do occur in sport. We know how important it is to treat those injuries properly and concussion is no different. This initiative is all about recognising the risk and changing attitudes to concussion, making the sporting environment as safe as possible for everyone.

While evolving evidence into head injuries in sport has been the driving factor in refreshing the guidelines, the overarching message remains the same: all concussions are serious – if in doubt, sit them out!

The appropriate assessment of a head injury sustained during sport requires a degree of training and knowledge beyond most of us. Remember there is no such thing as a “minor” head injury.

Don’t leave the casualty alone while waiting for help to arrive. Always err on the side of caution – if in any doubt then send them onto hospital.

Not all of us can be experts in head injury management. But I believe it is important for all who work in sport to have a level of sports first aid training.

Many governing bodies in sport now insist on this level of training. Formal training is readily available through voluntary organisations, and the Clinic at Hampden runs a nationally validated and endorsed Sports First Aid qualification ideal for those who work with teams and individuals. No prior knowledge is required. For details see www.hampdensportsclinic. com/sports-first-aid.